On weekends, medical researcher Wallace I. Sampson often leaves his suburban home and drives up the peninsula into San. Francisco. He sees himself as an investigator "his quarry, an epidemic that’s ravaging the City by the Bay." But it’s not the AIDS virus he’s after. Although a hematologist by training, Sampson is hunting tainted medicine, not tainted blood He’s a quackbuster.

In recent months, Sampson uncovered hucksters selling an unlicensed preparation allegedly containing interleukin2, an experimental drug not widely approved for clinical use against AIDS in the Battle Against Health Fraud United States. Sampson’s report contributed to the firm’s being put out of operation.

He also learned about "and issued a quack-alert concerning" a faith-healer he describes as "the Dallas Cowgirl cheerleader of AIDS patients." It seems this woman convinced AIDS sufferers that they can conquer the fatal disease simply by looking in a mirror and loving themselves.

And then there was a licensed doctor who Sampson claims to have found extracting substantial sums of money for taking AIDS patients’ blood, treating it with oxygen-3, and reinjecting it into the patients. Called "ozone therapy," such treatments have never been shown by any scientific study to be of any help to AIDS patients. So Sampson reported him to the California medical board.

To Sampson, such individuals are "sociopaths, highly self-centered con artists." He should know. He is a founding member of an organization called the National Council Against Health Fraud Inc.

The core of this 2,300-member "quackbusters, incorporated" is made up of nearly 1,000 physicians, scientists, and educators who are devoted to exposing medical fraud schemes, alerting governmental agencies to scams, and writing newsletters about the dangers of permitting such practices to proliferate.

"We got together in the late 1970s to do something jointly for public education," recalls Sampson, 58, who also teaches a course in "medical pseudoscience" at Stanford University’s School of Medicine. "It was during the laetrile era. We were fearful of the propaganda that comes with this type of fraudulent remedy. If public policy was made by those making fraudulent statements, like laetrile proponents, then society was in trouble. We thought it was time to swing the pendulum the other way." But the group’s crusade against what they see as an international propaganda machine spewing out "anti-science" faces heavy odds.

Authorities estimate that from $10 billion to $25 billion is spent annually on fraudulent and/or questionable remedies. Many of those pedding "alternative therapies" work through alliances of promoters, quasi-nutritionists and "freedom of choice" practitioners, such as those who advocate the use of laetrile, cyanide-laced tablets derived from apricot pits. They insulate themselves via corporate structure, move jurisdictions of operation to avoid legal action, and even go offshore to Mexico or the Bahamas when the heat gets too high. For example, a zoologist once involved in probing the mysteries of cancer moved to the Bahamas and set up an immune therapy clinic there after his research was repudiated in this country.

The National Council fights back on a tiny budget—$50,000 annually collected from small member-donations. "Sometimes you wonder why you do this; but if someone isn’t willing to stand up against quackery and fight for truth and honesty, then society is in a lot of trouble," says William Jarvis, president of the National Council. In 1976, Jarvis, a health educator at Loma Linda University’s School of Medicine, near Los Angeles, started the National Council’s forerunner, "the Southern California Council Against Health Fraud" with five individuals. Shortly thereafter, Sampson started a Northern California group following an evening meeting in the Berkeley home of Thomas Jukes. Jukes is the 82-year-old University of California biophysicist who in the late 1940s invented the first successful cancer chemotherapy, methatrexate. The two groups joined in 1984.

Jarvis has dedicated much of his academic career to the study of quackery. "When I started, no one was taking a systematic approach to quackery as a health problem," he said. "There was no epidemiology for quackery, like there is for cancer or drug abuse. So I sought to resolve the problem in the same manner as scholars approach other problems. I tried to look at the host factors, the causal agents, and the environment of quackery."

In a recent issue of the National Council’s four-page newsletter, for example, Jarvis reports on the results of several surveys of the types of patients drawn to holistic therapies. He goes on to examine how fad therapies are used to exploit families with a developmentally disabled child. And he points to similarities between the traits of some of the most notorious quacks and behavior patterns identified by psychologists as typical of psychopaths.

Council members do more than write scholarly treatises, however; many quackbusters actively confront their quarries. Take 55-year old Kansas City physician John Renner. Every so often, Renner will don special garb and wade among quacks, offering himself as a guinea pig. In January, he covered his head in bandages, got into a wheelchair, and rolled into a health conference where alternative therapies were advocated.

When left alone by his attendant, two quacks got in a fight over who was going to fleece him first, Renner says. "One was into colonies, and wanted to give me an enema; the other was a garlic salesman," he says. "They never even asked what I had. Later I told people I had a yeast infection. One guy wanted to draw my blood. He offered a ‘show special,’ $900 worth of tests for only $600. All he wanted was my Medicare number.

Council member Steven Barrett, an Allentown, Pa. psychiatrist, uses whole networks of volunteer undercover operatives to infiltrate unorthodox groups, for the National Council. Since the late 1960s, Barrett has been churning out reports on his inquiries. The results of his probes not only have been published in his monthly newsletter, "Nutrition Forum," but have become the grist for successful court actions against, multi-level marketing schemes (pyramid firms), Postal Service mail fraud convictions, and Federal Trade Commission probes of questionable marketing techniques at health food stores.

The quacks don’t always take the assaults of the quackbusters lying down; they have been known to fight back in kind. Intending to stage a protest at a recent convention the National Council had in Kansas City, an unorthodox— treatment promoter tried to impersonate a media reporter in order to gain access to the meeting. He was ejected, but he staged demonstrations outside the meeting every day for the duration-of the conference.

Every so often the quackbusters become the targets. Last year, for example, Peter Joseph Lisa, a proponent of alternative treatments, wrote -and published a book entitled “The Great Medical Monopoly Wars,” in which he attacked one of the National Council’s most respected members, Victor Herbert. Lisa questioned Herbert’s treatment of patients, challenged his military record, and made other allegedly defamatory assertions.

Herbert, a lab head at the Bronx, N.Y, Veterans medical center, is a renowned expert in hematology and nutrition. But because he has been testifying against quacks for decades in cases brought by the FDA and the U.S. Postal Service, he believes quacks have put him at the top of their "enemies list."

However, Herbert’s fellow council members knew that Lisa had aimed at a dangerous target. Says Jarvis, "He [Herbert] is a real fiesty guy, not afraid of anyone. He is the kind you need to fight quackery. This is not work for faint-hearted people."

Sure enough, Herbert’s blood boiled when he learned of Lisa's attack. Asked why he didn’t just ignore a book he himself believes would never be read by a reputable scientist, Herbert says: "They accused me of murdering patients. This is a malicious lie. That is not tolerable."

So Herbert sued. But while he was at it, he included more than a dozen proponents of unorthodox therapies as well as Lisa. Then he went one step further: his suit took on the American Quack Association, an informal group of alternative therapists that describes itself as being determined to "de-mythicize" the term "quack". This organization actually holds meetings across the street from the American Medical Association headquarters building in Chicago. According to Michael K. Botts, general counsel to the National Council Against Health Fraud, some of the American-Quack Association’s key players "have ridden the crest of every major health fraud in the last 20 years."

To members of the National Council, the Lisa book’s attack on Herbert may prove disastrous to the world of quackery. Botts, who is also Herbert’s attorney, expects the discovery process in the lawsuit filed last December to produce an unprecedentedly extensive record of the quackery industry’s far-reaching activities.

On still another front, earlier this year, Allentown psychiatrist Barrett and the National Council formed what Barrett feels will be "the most powerful anti-quackery method ever devised." It is called the Task Force on Victim Redress. "The National Council’s Task Force will help victims of quackery by getting them the competent legal assistance they need," reads the group’s statement of purpose. "It will serve attorneys as a clearing house for reliable information on the latest frauds and the experts who can help prove their cases. Help also will be available to insurance companies and law enforcement agencies."

"We will publicize the fact that if you are hurt or cheated, or if corrective action is necessary against a disreputable health-care practice, we will help," said Barrett, who chairs the seven-person group. To search out cases, the group will rely on its allies, like Sampson.

It’s not likely that the Task Force will run short of victims to help, just as there’s no shortage of bizarre targets. Take the Berkeley, Calif., institute that Sampson recently discovered to be using a classic money making scheme, where a quack will take "old methods" of medical chicanery and "redesign them" to exploit a new health problem. In this case, says Sampson, the institute is out to profit from the AIDS epidemic.

He asserts that the institute has long advocated a method of fighting cancer by means of "detoxifying" the patient, a process that includes lowering the patient’s body temperature and seeing that the patient drinks large quantities of water.

"They have now transferred this to AIDS," says Sampson. "They have men sitting around, not wearing underwear—so the testicles stay cooler and drinking distilled water. For’ this, they charge a couple of hundred. dollars."

Rex Dalton is a reporter for the San Diego Union.

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Dec 2005 Vol 23 No 12 (http://healthyskepticism.org/news/issue.php?id=19)Report on consultation with Healthy Skepticism subscribers and membersBy: Caroline SaxonCaroline has spent 3 months liaising with members, subscribers and the management committee to gauge opinion about future directions for Healthy Skepticism. This is the short version of her report. A more detailed account will be posted on this website soon.

Oct 2005 Vol 23 No 10SSRI Lawyer Corrects New York Times Report ( http://healthyskepticism.org/news/issue.php?id=17 )By: Karen Barth MenziesThe FDA's recent warnings regarding suicidality and SSRI antidepressants were appropriate and long overdue, based on scientific evidence and the FDA's warning responsibilities to consumers as directed by the Code of Federal Regulations. The article published in the New York Times on August 6, 2005 by Gardiner Harris, titled FDA Responds to Criticism with New Caution asserts the erroneous thesis that the FDA simply yielded to criticism and issued invalid warnings, casting a cloud of doubt over the legitimacy of the warnings. That the FDA finally stepped up to shield consumers instead of pharmaceutical companies should be applauded, not undermined with inaccurate reporting. People died as a result of absent warnings while the SSRI antidepressants were marketed and sold as harmless.

Sep 2005 Vol 23 No 9 ( http://healthyskepticism.org/news/issue.php?id=15 )Submission from Healthy Skepticism re RACP Ethical GuidelinesBy: Peter Mansfield, Wendy Rogers and Jon JureidiniThe Royal Australasian College of Physicians (RACP) is the college for medical specialists in Australia and New Zealand. RACP is revising its Ethical Guidelines and invited Healthy Skepticism to make a submission. Peter Mansfield and Jon Jureidini wrote part 1 of our submission. Part 2 was written by medical ethicist and HS member Wendy Rogers. RACP's May 2005 draft Ethical Guidelines are available at: www.racp.edu.au/public/news_ethics.htm

Heather Carter

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For those who want to see an important difference between real science and medicine, and the world of so-Called "Alternative" Medicine (sCAM), the following reveals science in action - punishing its own. Misconduct standards do exist, and they are constantly being improved. Fraud isn't tolerated, and the system has ways of dealing with it. It doesn't always work perfectly (otherwise the following article wouldn't have been written!), but at least a system is in place, and that's more than can be said for sCAM, where there are no controls at all, and seemingly little concern for truth. In fact, most sCAM practices are usually synonymous with quackery, and often involve fraud.

Global Trend: More Science, More Fraud

By LAWRENCE K. ALTMAN and WILLIAM J. BROADPublished: December 20, 2005

The South Korean scandal that shook the world of science last week is just one sign of a global explosion in research that is outstripping the mechanisms meant to guard against error and fraud.

Experts say the problem is only getting worse, as research projects, and the journals that publish the findings, soar.

Science is often said to bar dishonesty and bad research with a triple safety net. The first is peer review, in which experts advise governments about what research to finance. The second is the referee system, which has journals ask reviewers to judge if manuscripts merit publication. The last is replication, whereby independent scientists see if the work holds up.

But a series of scientific scandals in the 1970's and 1980's challenged the scientific community's faith in these mechanisms to root out malfeasance. In response the United States has over the last two decades added extra protections, including new laws and government investigative bodies.

And as research around the globe has increased, most without the benefit of such safeguards, so have the cases of scientific misconduct. Most recently, suspicions have swirled around a dazzling series of cloning advances by a South Korean scientist, Dr. Hwang Woo Suk.

Dr. Hwang's research made him a national hero. His team outdid rivals by claiming to have extracted stem cells from cloned human embryos and to have cloned a dog, an extraordinary feat. Some observers hailed the breakthroughs as worthy of a Nobel Prize.

Last month, critics charged that Dr. Hwang's published findings hid ethical lapses. And last week, collaborators accused the researcher of fabricating results in one of his landmark human cloning studies, published in Science last spring.

Dr. Hwang has insisted on his innocence but said he would retract the Science paper. Now questions are growing about his earlier work, including Snuppy, the dog he claims to have cloned. Yesterday, news agencies reported that Seoul National University officials investigating Dr. Hwang's claims locked down his laboratory, impounded his computer and interviewed his colleagues, among other actions.

"The Korean case shows us that we should be a lot more cautious," Marcel C. LaFollette, the author of "Stealing Into Print: Fraud, Plagiarism, and Misconduct in Scientific Publishing," said in an interview. "We have been unwilling to ask tough questions of people who are from other countries and whose systems are different because we were attempting to be polite."

To be sure, most scientists resist pressures to cut corners and adhere to the canons of science, honoring the truth above all else. But surveys suggest that there are powerful undercurrents of misbehavior and, in some cases, outright fakery.

In June, a survey of 3,427 scientists by the University of Minnesota and the HealthPartners Research Foundation reported that up to a third of the respondents had engaged in ethically questionable practices, from ignoring contradictory facts to falsifying data.

Scientific fraud as a public danger burst into public view in the 1970's and 1980's, when major cases of misconduct shook a number of elite publications and institutions, including Yale, Harvard and Columbia.

In 1981, Dr. Donald Fredrickson, then the director of the National Institutes of Health, defended the standard view of science as a self-correcting enterprise. "We deliberately have a very small police force because we know that poor currency will automatically be discovered and cast out," he said.

But fraud after fraud made the weaknesses of that system impossible to ignore. In the early 1980's, a young cardiology researcher, Dr. John R. Darsee, was found to have fabricated much data for more than 100 papers he wrote while working at Harvard and Emory Universities. His work appeared in The New England Journal of Medicine, The Proceedings of the National Academy of Sciences and The American Journal of Cardiology, among other top publications.

Startled, the federal government, beginning in 1985, took steps to augment the existing safeguards. For instance, Congress passed a law requiring public and private institutions to establish formal ways to investigate charges of fraud, in theory helping to assess damage, clear the air and protect the innocent. Eventually, the federal government established its own investigative body, now known by the Orwellian title of the Office of Research Integrity.

Journal editors, at the center of the storm, also took collective action to enhance their credibility. In 1997, they founded the Committee on Publication Ethics, or COPE, "to provide a sounding board for editors who are struggling with how to best deal with possible breaches in research and publication ethics," according to the group's Web site.

Consisting mostly of editors of medical journals, the committee now has more than 300 members in Europe, Asia and the United States.

Still, the frauds kept coming. In 1999, federal investigators found that a scientist at the Lawrence Berkeley Laboratory in Berkeley, Calif., faked what had been hailed as crucial evidence linking power lines to cancer. He published his research in The Annals of the New York Academy of Sciences and F.E.B.S. Letters, a journal of the Federation of European Biochemical Societies.

The year 2002 proved especially bleak. At Bell Labs, a series of extraordinary claims that seemed destined to win a Nobel Prize, including the creation of molecular-scale transistors, suddenly collapsed. Two of the world's most prestigious journals, Science and Nature, had published many of the fraudulent papers, underscoring the need for better safeguards despite two decades of attempted repairs.

Experts now say that the explosive growth of science around the globe has made the problem far worse, because most countries have yet to institute the extra measures that the United States has put in place. That imbalance is at least partly responsible for a rise in scientific scandals in other countries, they say.

Dr. Richard S. Smith, a former editor of The British Medical Journal (now BMJ) and the co-founder of the Committee on Publication Ethics, a group of journal editors, said in an interview that fraud was becoming increasingly difficult to root out because most countries' protective measures were either patchy or altogether absent. "It's hard enough to do something nationally, and to do it internationally is still harder," he said. "But that's what is needed."

Contributing to the problem is a drastic rise in the number of scientific journals published around the world: more than 54,000, according to Ulrich's Periodicals Directory. This glut can confuse researchers, overwhelm quality-control systems, encourage fraud and distort the public perception of findings.

"Foreign scientific journals have gone through the roof," said Shawn Chen, a senior associate editor at Ulrich's, nearly doubling to 29,098 in 2005 from 15,300 in 1980. "We're having a hard time keeping up."

While millions of articles are never read or cited - and some are written simply to pad résumés - others enter the pressure cooker of scientific and biomedical promotion, becoming lucrative elements of companies' business strategies.

Until now, cases of questionable research in other countries have gotten little attention in the United States. But international editors, shaken by scandal, are now publicizing them and expressing concern. This year, the July 30 issue of BMJ devoted four articles to the subject, asking on its cover: "Suspicions of fraud in medical research: Who should investigate?"

The articles discussed cases in which several publications, including BMJ, had stumbled in resolving serious doubts about the truthfulness of published studies done in Canada and India. The Canadian research claimed that a patented mix of multivitamins improved brain function in older people, and the Indian study said that low-fat, high-fiber diets cut by nearly half the risk of death from heart disease.

The BMJ said that it published its own version of the Indian research in April 1992 and that it had later investigated serious questions about the validity of the research for more than a decade before speaking out.

The difficulty, the editors said, was that journals could go only so far in fraud inquiries before needing the aid of national investigative bodies and professional associations that oversee scientific research. But in the Indian and Canadian cases, they added, such bodies either did not exist or refused to help, so "the doubts are unresolved."

The journal's editors, Dr. Fiona Godlee and Dr. Jane Smith, noted that the United States and Scandinavian countries had adopted institutional defenses and that Britain was considering such safeguards. Journals have an obligation to help the process, they concluded, by publicizing their difficulties and doubts.

Most recently, the South Korean uproar illustrates the tangle of publishing and policing issues that can arise as science becomes increasingly competitive and international.

"Now we're in a situation where we have these alliances between university researchers in countries and between institutions that really weren't working together before," said Dr. LaFollette, author of "Stealing Into Print."

The journal Science, owned by the American Association for the Advancement of Science, published the research of Dr. Hwang of Seoul National University and his colleagues in March 2004 and June 2005, hailing it as pathbreaking.

On Dec. 14, the magazine noted in a statement how fraud charges about the 2005 research had led to two investigations - one in South Korea and the other at the University of Pittsburgh, home to one of the article's 25 co-authors. "The journal itself is not an investigative body," Donald Kennedy, the magazine's editor, argued. "We await answers from the authors, as well as official conclusions, before we come to any ourselves."

On Friday in a news conference, Dr. Kennedy emphasized that the magazine had made no accusations of fraud against Dr. Hwang. "As of now we can't reach any conclusions with respect to misconduct issues," he said.

Independent scientists said it remained to be seen how thoroughly authorities in South Korea, where Dr. Hwang is a celebrity, would investigate the case and resolve knotty issues in what amounts to a highly public test of institutional maturity.

Seoul National University is leading the inquiry. Its committee, which apparently has the authority to examine Dr. Hwang's raw data and to question his colleagues, may have the best chance of discovering how much of his work remains valid.

But experts also cautioned that the committee's credibility requires the addition of outsiders, and perhaps scientists from other countries, who know the field and can help ensure that the investigation will retain its objectivity.

"Unfortunately, individual institutions have an enormous conflict of interest," said Dr. Smith, the former editor of The British Medical Journal. "It's a lot easier," he said, for such bodies when examining an allegation of fraud on their own, "to slide someone out of the organization or to suppress it altogether."

An outspoken medical professor has condemned two widely-used alternative therapies, homeopathy and chiropractic.

Britain’s first professor of complementary medicine stood by his views as he warned he may have to quit Exeter University.

Professor Edzard Ernst was appointed to the university in 1993 with the aid of a £1.5 million grant from builder Maurice Laing.

Yesterday the professor said repeated studies had failed to establish significant benefits from homeopathy or chiropractic.

He said there was good evidence for some herbal treatments.

Careful studies by the university had shown that arnica made no difference to injuries and treatments had also failed to help children with asthma.

He told the Observer: "The treatments do no good. But the long interview - about an hour-and-a-half - carried out by an empathetic practitioner during diagnosis may explain why people report improvements in their health.

"However, that kind of attention cannot be afforded by the NHS. If it were true, we would have to tear up all our physics and chemistry textbooks."

A spokesman for Exeter University told the paper: "Professor Ernst’s department has enough money to go on for a couple of more years. We are still trying to raise cash. It is premature to talk of closure."

Date: December 20th 2005

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Monday, December 19, 2005

There is no evidence of specific benefit with chiropractic for headache. It was no better than oral amitriptyline over six weeks.

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Systematic review

These two reviews appear to have found much the same trials using slightly different search strategies. They also used different methods of quality scoring, with those in the Astin review somewhat more familiar.

The trials found examined a variety of different types of headache, including tension headache, migraine, and others. Two trials comparing chiropractic with oral amitriptyline found no difference over about six weeks. Four studies used a sham chiropractic compared with true spinal manipulation came to no agreement.

It was unclear how much any effects observed could be due to chiropractic or other, non-specific, factors.

Comment

There is no evidence of specific benefit with chiropractic for headache.

Sunday, December 18, 2005

'You might as well take a glass of water,' fumes complementary medicine expert in university funding battle

Robin McKie, science editorSunday December 18, 2005The Observer

Millions of people use it to deal with illnesses ranging from asthma to migraine. Prince Charles believes it is the answer to many of the evils of modern life. But now Britain's first professor of complementary medicine, Edzard Ernst of Exeter University, has denounced homeopathy as ineffective.

'Homeopathic remedies don't work,' he told The Observer. 'Study after study has shown it is simply the purest form of placebo. You may as well take a glass of water than a homeopathic medicine.' Nor is Ernst's disdain confined to homeopathy. Chiropractic, which involves spine manipulation to treat illnesses, and the laying on of hands to 'cure' patients, are equally invalid, he says.

Not surprisingly, his views and his studies have provoked furious reactions. Chiropractors and homeopaths have written in droves to Exeter to denounce him. But now the scourge of alternative medicine says he is going to have to quit because Exeter will no longer support him or his department. 'They have never provided me with the money they originally promised me. Now we have been told in no uncertain terms that this department is going to close.' The university denied the charge. 'Professor Ernst's department has enough money to go on for a couple of more years,' said a spokesman. 'We are still trying to raise cash. It is premature to talk of closure.'

Ernst's department was created in 1993 when Exeter was given £1.5 million by construction magnate Maurice Laing. When accepting these funds, Ernst said the university promised to raise the same amount again. 'They never did,' he added. Ernst, then a professor of rehabilitation medicine in Vienna, took the job to bring scientific rigour to the study of alternative medicines, an approach that has made him a highly controversial figure in the field. An example is provided by Ernst's study of arnica, given as a standard homeopathic treatment for bruising.

'We arranged for patients after surgery to be given arnica or a placebo,' he said. 'They didn't know which they were getting. It made no difference. They got better at the same rate, whether they got arnica or the placebo. And arnica is a classic homeopathic remedy. It doesn't work, however.'

In another study, Ernst got five homeopaths to examine children with asthma. 'Children are supposed to respond better than adults to homeopathy, and asthma is said to be particularly responsive to homeopathic treatments,' he said. 'However, again we found no evidence that homeopathy worked.'

Yet thousands of people swear by it. Britain has five homeopathic hospitals, which are funded by the NHS. 'The treatments do no good,' said Ernst. 'But the long interview - about an hour-and-a-half - carried out by an empathetic practitioner during diagnosis may explain why people report improvements in their health. However, that kind of attention cannot be afforded by the NHS.' The incredibly dilute solutions used by homeopaths also make no sense, he added. 'If it were true, we would have to tear up all our physics and chemistry textbooks.'

Nevertheless, Ernst insists that he is a supporter of complementary medicines. 'No other centre in the world has produced more positive results than we have to support complementary medicine,' he said. 'Herbal medicine, for instance, can do good. If I was mildly depressed, I think St John's wort would be a good treatment. It has fewer side-effects than Prozac. Acupuncture seems to work for some conditions and there are relaxing techniques, including hypnotherapy, that can be effective. These should not be used on their own, but as complements to standard medicines.'

Not surprisingly, Ernst has been attacked by chiropractors and homeopaths who passionately defend their techniques. The latter point to studies which they say show that most patients they treat are satisfied and cite an analysis in the Lancet of 89 trials in which their medicines were found to be effective. The Smallwood report, commissioned by Prince Charles, has called for more complementary medicines, particularly homeopathy, to be given on the NHS.

Ernst's opponents also claim some of his research methods are unethical. Once, a colleague pretended to be a pregnant mother and asked homeopaths and chiropractors if she should give the MMR vaccine to her child. Most said no. Ernst published a paper on these findings.

The British Chiropractic Association told the university it would be better served by an individual who was 'genuinely interested' in complementary medicine.

HomeopathyInvented 250 years ago by a German doctor, Samuel Hahnemann, homeopathy is based on the idea that, if a particular drug or chemical causes a medical problem, it should also act as a cure, though only in an almost infinitely dilute state. There are about 3,000 registered homeopaths in the UK and 21 per cent of GPs offered a homeopathy service in 2001 compared with 17 per cent in 1995. Skin disease, irritable bowel syndrome and depression are among the ailments supposed to be improved by homeopathy.

Herbal medicinePlants or plant derivatives are used in herbal medicine to treat, prevent or cure various ailments. The approach has been used since 1500BC by the Egyptians. Today there are many branches, including Ayurveda, Chinese, Tibetan and Western herbal medicine. Popular remedies include echinacea, ginger, garlic, peppermint, feverfew, elderberry, goldenseal, St John's wort (below), ginseng and ginkgo. Consumers in Britain spend £126 million a year on herbal remedies to treat conditions such as constipation, diarrhoea and indigestion.

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ChiroPlot: the scheme to scam the competition.

ChiroPlot: the scheme to scam the competition.

Summary:- The chiropractic profession (not necessarily individual DCs) has a Lebensraum politic, in other words it needs to steal customers from others in order to survive. It simply wishes to bury the competition. All talk of cooperation is a smokescreen.

***

The chiropractic agenda is no longer a secret. That agenda is to reserve all spinal manipulative therapy (SMT) for itself, by denying others - most notably Physical Therapists, but also including MDs and DOs - the right to use it at all for any reason. Regardless of its success or failure in its attempts, the agenda remains the same, and it will continue to pursue it until it either succeeds or the profession is forced to lower its ambitions in order to manage to survive at all.

Their agenda is a uniquely greedy one. They not only wish to reserve the use of SMT for their own illegitimate purposes, they wish to deny others the right to use it for legitimate purposes. Unfortunately, in their zeal to reserve a niche that is uniquely their own, they don't stop there.

What they are attempting to do can be better understood by using an illustration, so let's substitute the word "language" for the phrase "SMT":

What they wish to do is to reserve a specific dialect of a certain "language" for themselves. The "language" is spoken by several other groups. The others would have no objection, if chiropractic didn't also demand that no one else spoke the "language" at all. They are not content with simply using the dialect themselves, but are quite ambitious and greedy.

The "language" is SMT, and it is spoken by MDs, DOs, PTs and DCs. It's a very old "language", since manipulation has been practiced for thousands of years, long before D.D. Palmer claimed to receive his chiropractic concepts - in spiritistic seances - from the long dead medical physician, Dr. Jim Atkinson.

The practice of chiropractic is legally defined as "manual manipulation of the spine to correct a subluxation". Manual manipulation is not what is unique about chiropractic. It is the *reason* for manipulating that is unique, and that part is in the last four words - "to correct a subluxation."

MDs, DOs, PTs and DCs use SMT for various reasons.

Only DCs do it "to correct a subluxation."

Their intention is to prevent MDs, DOs, PTs from using SMT for *all* reasons.

The lawyers representing the AMA, APTA, and AOA need to understand this matter.

Regarding subluxations, chiropractic's foremost historian has this to say:

".... when we insist upon attributing beneficial clinical outcomes to reduction of the subluxation complex, we engage in dogma. The subluxation complex is a potentially testable hypothetical construct. It may have great clinical significance, or none, or something somewhere in between. We don't know; we haven't done our homework. The validity (or lack thereof) of the traditional chiropractic lesion has not been adequately explored (far from it). Dr. Riekeman acknowledges that "the hard questions in chiropractic have never been answered by science," but more to the point, they are rarely if ever asked. The president will query, "What is subluxation?" but he doesn't ask whether subluxation complex is real, meaningful, pr clinically useful. To do so would be to challenge the dogma of Palmer." -- Joseph Keating Jr.,PhD, Homewood Professor, Canadian Memorial Chiropractic Collegehttp://www.chiroweb.com/archives/19/19/20.html

Manipulating a biotheological fiction is what chiropractic is all about, and chiropractors who don't do this aren't truly practicing "real" chiropractic, but are practicing something more akin to Physiotherapy, without being properly educated to do so.

The history of chiropractic is a tragic one. It is the story of a business enterprise based on privately owned schools. Their job has been to fool students into accepting belief in the chiropractic "subluxation". These students become chiropractors who in turn fool their patients into believing in this fiction. A belief in "subluxations" is the most fundamental element of the profession, and constitutes its uniqueness. "No subluxation, no chiropractic!"

Using the legal terminology that defines their profession, chiropractic leaders and their lawyers are constantly engaged in legal maneuvers and lawsuits designed to control, limit, and prosecute the members of other professions who use their rights to manipulate.

They do it even when the person in question has not performed a manipulation in an attempt "to correct a subluxation".

The President of the American Chiropractic Association has clearly described their intentions:

"While the ACA views the decision on physical therapists as a victory in itself, our fight is certainly not over. Nobody but a doctor of chiropractic is qualified to perform manual manipulation to correct a subluxation-not a medical doctor, not an osteopath. We will continue to pursue this lawsuit until we're assured that only doctors of chiropractic are allowed to provide this service to Medicare + Choice beneficiaries."

Thursday, December 15, 2005

The chiropractic juggernaut crashes ahead, moving the profession away from reform, and cementing its position as a pseudoscientific, biotheological business enterprise, all the while pretending to be a healthcare profession.

Chiropractic is to science, what Scientology is to religion.It is just as much a pseudoscience, as Scientology is a pseudoreligion.

The following is a press release from the American Chiropractic Association, announcing their victory in fooling the courts into legalizing the fiction of treating a non-existent entity, the chiropractic "subluxation".

On this matter I agree with chiropractic. Their legal basis for licensure is based on this very carefully worded phrase:

"manual manipulation of the spine to correct a subluxation".

The last four words are crucial to their whole argument, and they are right!

MDs, Osteopaths, and Physical Therapists can manipulate the spine and other joints, but only chiropractors believe in the existence of chiropractic "subluxations", which are not the same thing as real, objectively verifiable and symptomatic orthopedic subluxations.

A chiropractic "subluxation" can be defined by any chiropractor to be anything he or she wishes it to be. No "subluxation" can reliably and predictably be found by any two chiropractors. They have been discussing its existence and definitions for 111 years.

According to chiropractors, a "subluxation" doesn't have to be objectively verifiable by any means. It doesn't have to be symptomatic, and it always exists in all people, from birth to death. Since it doesn't necessarily have any symptoms, its treatment doesn't necessarily cause the relief of any symptoms. That "pop" has a great placebo effect, and the indoctrinated patient believes what their chiropractor claims - that a bone has been pushed back in place, that a joint has been adjusted. Hogwash!

Chiropractors are defending this basic dogma:

1. That spinal manipulative therapy (SMT) - known by chiropractors as "adjustments" - is essential for all people: newborns, the aged, healthy and unhealthy.

2. That "adjustments" should be used in practically every single treatment session, no matter what the diagnosis, since chiropractic usually ignores medical diagnoses in favor of the universal chiropractic diagnosis - the presence of damaging "subluxations", also termed the "vertebral subluxation complex" (VSC).

3. That "adjustments" promote health and prevent disease in the whole body, and that their effects are not merely limited to the structures around the joints being "adjusted".

4. That regular "adjustments" are necessary - even for asymptomatic individuals - in order for them to remain healthy.

Chiropractors wish to legally reserve a niche for themselves. Since that niche is the manipulation of a biotheological fiction, let them do it! They are doing a good job of painting themselves into precisely that corner of a cave, where the light can't shine.

In the process, we must make sure that they don't succeed in forbidding everyone else from manipulating the spine and other joints for other, more legitimate (and rare) reasons.

"ACA lobbyists, Ted Mullenix and Julie Grinder, had several meetings with both the sponsor the bill and the Physical Therapy Association lobbyist. They offered us several proposals including a bill that would include “manipulation” but exclude “chiropractic manipulation.” Our message was, in no uncertain terms, and will be there is no compromise on manipulation!" (emphasis added)

and another one showing just how far they are planning to go (in this case with acupuncturists):

CMS Letter Does Not Restrict PTsPhysical therapists are not restricted in providing services they have historically furnished to Medicare+Choice beneficiaries¾or in their ability to bill for those services as before¾under an Operational Policy Letter (OPL) recently issued by CMS.....

CMS Letter Does Not Restrict PTsPhysical therapists are not restricted in providing services they have historically furnished to Medicare+Choice beneficiaries¾or in their ability to bill for those services as before¾under an Operational Policy Letter (OPL) recently issued by the Centers for Medicare and Medicaid Services (CMS).

The letter addressed the question of "which practitioners are authorized by law to perform manual manipulation of the spine to correct a subluxation as a Medicare-covered service," as covered in the Feb 8 issue of PT Bulletin Online.

After analyzing the letter, APTA notes that the CMS Operational Policy Letter applies only to Medicare+Choice, and not to traditional fee-for-service Medicare (Part B). More important, the OPL expressly applies only to manual manipulation of the spine to correct a subluxation. Consequently, APTA believes that physical therapists may continue to furnish manual manipulation of the spine for any other purpose to Medicare+Choice beneficiaries, as long as they practice within the scope of their state licensure. (bold emphasis added)

Based on preliminary discussions, it is APTA’s understanding that CMS and Department of Health and Human Services (HHS) officials do not disagree with APTA’s position on this issue. CMS officials have indicated that the OPL is limited in scope and applies only to manual manipulation of the spine to correct a subluxation. Further, CMS/HHS continues to oppose the lawsuit brought by the American Chiropractic Association (ACA), in which the ACA seeks to (a) declare chiropractors the exclusive providers of manual manipulation services to correct a subluxation; and (b) prohibit physical therapists from providing any manual manipulation of the spine services to Medicare+Choice beneficiaries. APTA has sought to intervene in the lawsuit, and has filed briefs opposing the ACA’s substantive arguments. The case is pending.

ARLINGTON, Va.--(BUSINESS WIRE)--Dec. 14, 2005--The U.S. Court of Appeals has reversed a lower court decision allowing medical doctors and osteopaths to perform "manual manipulation of the spine to correct a subluxation" on Medicare beneficiaries, paving the way for chiropractors to pursue further hearings on the issue under a new administrative review process enacted in 2003. The Dec. 13 decision represents a major step in the American Chiropractic Association's (ACA) landmark lawsuit against the U.S. Department of Health and Human Services (HHS) and comes at a critical time as millions of Medicare patients are choosing Medicare managed care plans as part of their new prescription drug benefit.

"The ACA is extremely pleased that the District Court's ruling allowing M.D.s and D.O.s to provide a uniquely chiropractic service was nullified," announced ACA President Richard Brassard, DC. "We are happy that the issue is now whether or not a practitioner is 'qualified,' not whether or not a practitioner is simply licensed. The ACA's position has been and remains that only chiropractors are qualified by education and training to correct subluxations. Because of the appeals court's decision, chiropractors can continue to fight to safeguard their right to be the sole providers of this service and to ensure Medicare patients' rights to access doctors of chiropractic."

In its Dec. 13 opinion, a three-judge appeals panel overturned an Oct. 14, 2004 District Court ruling that stated: "The court will simply reiterate its conclusion that 42 U.S.C. 1395x(r) does not prevent doctors of medicine and osteopaths from performing a 'manual manipulation of the spine to correct a subluxation.'" The appeals panel ruled that the District Court lacked the jurisdiction to make this decision and that the final decision must be made through a newly revised appeals process. Through this process, individual chiropractors file complaints on behalf of their Medicare patients through the managed care organization. From there, complaints move to an administrative law judge.

The appeals panel further questioned the District Court's opinion on the issue of which health care providers are qualified to provide the chiropractic service - not simply which providers have a license to do so. "The regulation states that '(I)f more than one type of practitioner is qualified to furnish a particular service, the HMO ... may select the type of practitioner to be used.' ... (emphasis added). The HMO's invocation of this provision would squarely present the question of whether medical doctors and osteopaths, as well as chiropractors, are 'qualified to furnish' the service of manual manipulation of the spine to correct a subluxation." According to ACA's legal team, this language suggests that simply possessing a medical or osteopathic license will not be sufficient to provide the chiropractic service; the MD or osteopath must prove that they are qualified to do so by education and training.

"The appeals court decision is especially significant as seniors are being encouraged to join Medicare managed care programs in which they will find no meaningful chiropractic services," added Dr. Brassard. "Doctors of chiropractic nationwide must familiarize themselves with the new appeals process and report on any Medicare HMO that does not offer chiropractic services through doctors of chiropractic."

The ACA is exploring ways it can assist individual doctors of chiropractic through the administrative review process and provide them with the resources and materials they need to establish their unique qualifications to an administrative law judge, if necessary.

Earlier court rulings in ACA's lawsuit against HHS, filed in 1998, have also resulted in "monumental victories for Medicare patients," according to Dr. Brassard - the most important being the decision prohibiting physical therapists from providing manual manipulation of the spine to correct a subluxation to Medicare patients. "Before ACA filed its lawsuit," Dr. Brassard explained, "Medicare HMOs were given the green light to misappropriate taxpayer dollars to pay non-physician physical therapists to deliver the chiropractic physician service of 'manual manipulation of the spine to correct a subluxation' under Medicare - or to deny the service to beneficiaries altogether. That unfair and illegal practice has ended as a direct result of our lawsuit."

Other victories that occurred as a direct result of the HHS lawsuit were:

-- The preparation and release of a government study showing the virtual elimination of chiropractic services to Medicare beneficiaries entering the Medicare Managed Care system where there is a medical doctor gatekeeper requirement;

-- And, a government mandate that all Medicare Managed Care plans must make available and pay for manual manipulation of the spine to correct a subluxation.

** Nullifies lower court decision stating that MD's and DO's could perform manual manipulation of the spine to correct a subluxation on Medicare beneficiaries, ruling that the lower court did not have the jurisdiction necessary to make that decision;

** Decides that the federal courts are not currently the best place for determining the issue of which providers are best qualified to perform manual manipulation of the spine to correct a subluxation, cites a mechanism within the new Medicare Part C appeals process

Count 3 is more difficult. This alleges that the Secretary misinterpreted § 1395x(r) to mean that not only chiropractors, but also medical doctors and osteopaths could provide covered services when they manually manipulated an enrollee’s spine to correct the condition mentioned above. Suppose an HMO permitted enrollees to receive this service from a medical doctor or an osteopath or a chiropractor. Suppose also that a participating chiropractor became a party to an administrative proceeding in the manner just outlined. There would be a dispute about the referral requirement, but that goes to Count 4. Count 3 deals with who may provide the service. By hypothesis, a chiropractor would have provided the service, and everyone agrees that § 1395x(r) covers chiropractors. We can think of no reason why an administrative decision-maker would reach out to decide whether medical doctors and osteopaths may also do so. The possibility of judicial review at the end of the proceedings would be worthless. No court would adjudicate a claim that was not in controversy.

It would be another matter entirely if the HMO provided that only medical doctors and osteopaths could furnish the service at issue here. According to the Secretary’s report to Congress, twenty-two percent of HMOs have such a restriction. See note 1 supra. An enrollee in such an HMO could enlist the services of a chiropractor and, as we discussed with respect to Count 4, the chiropractor could become the enrollee’s assignee. (As with Count 4, amounts in controversy may be aggregated to obtain judicial review.) The chiropractor could then file an administrative claim, arguing that the HMO must reimburse him even though the HMO allows reimbursement only for medical doctors and osteopaths. At this point the HMO would be expected to defend on the ground that a regulation entitles it to restrict the type of practitioners who may provide a service. The regulation states that “[i]f more than one type of practitioner is qualified to furnish a particular service, the HMO . . . may select the type of practitioner to be used.” 42 C.F.R. § 417.416(b)(3) (emphasis added). The HMO’s invocation of this provision would squarely present the question whether medical doctors and osteopaths, as well as chiropractors, are “qualified to furnish” the service of manual manipulation of the spine to correct a subluxation. It follows that chiropractors could receive an administrative decision on the issue presented in Count 3 and that under Illinois Council the district court had no jurisdiction to decide that claim.

We therefore affirm the district court’s judgment with respect to Count 4. With respect to Count 3, we reverse the judgment on the ground that the court lacked jurisdiction.

Wednesday, December 14, 2005

BECOME AN EFFECTIVE CHIROPRACTIC SPEAKER

Successful and unsuccessful Doctor of Chiropractic It's the difference between the winners and losers.the have's and have not's.the weak and the strong. It's seeing, or not, yourself as a LEADER in your community .and developing rock-solid effective Chiropractic Speaker.... and the fastest, most effective way to achieve it is through powerful public speaking following this STEP-BY-STEP manuscript.

"I guarantee you that you never ceases to amaze people with your intelligent, well-educated, and ambitious individual frequently overlook the #1 skill that is guaranteed to position you ahead of the crowd...namely the ability to speak eloquently with potential patients."

Powerful Chiropractic Speaking Can Catapult Your Confidence And Thrust You Into A Position Of Leadership And Authority

A Chiropractic speaking is the single most important skill you can possess as a leader. It's a magical skill that can bring you mega-success to your practice. Becoming a persuasive Chiropractic Speaker gives you the power and privilege to influence people to your way of thinking and bring them to your Clinic. It gives you the confidence and charisma to get what you want, live your dreams, and help others do the same.

All Great Leaders Seem To Agree On One Principle: If you want to be great at something, seek the counsel of men who are great - and then follow their instructions to the letter. Well, this is the manuscript that instruct you teach how to become a Leader in your Community.

The purpose of this STEP-BY-STEP manuscript is to provide you the basic strategies for presenting technical and chiropractic business information in an oral presentation. You will use many of the same strategies in developing an oral presentation that you use in preparing an effective written document.

WHY SHOULD I BECOME A CHIROPRACTIC SPEAKER?

Talking about what you do is exciting, fun, and great publicity. When I owned my clinic, those first talks to local service organizations lead to many more invitations. My talks directly increased my practice. How did I know? If I spoke in the morning, three or four members of that audience usually made appointments by lunchtime the same day. Even though your practice may be in insurance, advertising specialties, or printing, I guarantee that an effective talk is going to bring you recognition and eventual number of patients.

WHAT DO I TALK ABOUT?

What do you know that other people want to know about? What do you know that other people SHOULD know? What are the questions people ask you most often about your practice, or profession field, or even hobbies or interests?

One of the forms of quackery that even some PTs have adopted is Myofascial Release (MFR). Fortunately as a student I was suspicious and didn't buy into it. Later I took a CE course and became totally convinced it was off the wall. Below is a humorous commentary on the subject from Bob Shutes, PT:

Please Release Me, Let Me Go

There I was, sitting quietly in class, so eager for knowledge, so ready to learn. Like a true scout, I was also willing to give my body to science. Luckily for me, that’s how I missed falling headlong into professional dementia. And to think it all happened in an accredited continuing education class I had paid good money to attend! Little did I know that I was going to take part in a myofascial release ceremony that was woven into the lymphedema course I had signed up for.

The lymphedema training seemed well enough supported by my memories of anatomy and physiology but what really intrigued me were the MFR rituals that were performed in class. That’s when innocent minds began crashing all over the room and I was thankful to be safely supine on a plinth while it happened. I began to wonder if therapists actually get paid for this and how in the world the profession reconciles this kind of “treatment” with our quest for “evidence based practice.” Maybe we should consider doing away with the DPT altogether and openly declare our intent to become shamans, witch-doctors and goofballs instead.

The initiation ceremony began with yours truly supine on a plinth in the middle of the room. With an absolutely straight face my course presenter began holding her palms a few inches above my torso. After a few hushed moments she intoned that she was beginning to feel some warmth over my right shoulder! This was taken to be a pretty neat clinical observation by just about everyone present. As for me I couldn’t resist the temptation to remark in a stage whisper, “I am a mammal!” Wasn’t that ever presented in our lecture halls? “Yes class, today we want to review some interesting characteristics about the patients we treat. They are warm-blooded creatures known as mammals and you will feel warmth when you place your hands near them. In the event that you do not feel any warmth you can assume your patient is either a reptile or is dead. In either case you should stop treatment until you have consulted with the referring physician to verify species and life.” Suddenly I knew I was going to have more fun than anyone else in the room.

Once my warmth had been verified it was time to begin “unwinding” my right upper extremity which (unbeknownst to me) had apparently gotten pretty wound up. My instructor began applying vigorous manual traction to my right arm and then began to slowly and magically circumduct it, all the while telling the class (and I’m not kidding here) “I am not moving his arm! It’s moving all by itself!”

With mouths rounded in slack-jawed wonder, my classmates were transfixed. Suddenly I realized that we had all descended into a “Far Side” moment and I found myself wishing that Gary Larson were there to capture the event. Temptation came my way and once again I could not resist it. When a classmate asked if my arm was really moving all by itself I said “No, not at all, she’s pulling it around pretty hard.” Not to be dismayed by my remark the instructor confidently told me “No I’m not! It just feels that way to you.” And then to the group “I’m not doing anything at all. It wants to unwind all by itself!” All I could do was grin and think, ”Please! Release my old fascia or you’re going to pull my arm off!”

Later during a failed attempt to unwind my arm during lab my partner said “Am I doing something wrong? It’s not moving like it did for the instructor.” When I replied that, “You have to pull it around like she did in order for it to move that way.” my dear lab partner said, “But she said she wasn’t moving it at all!” I tried to let her down easy. “Did you really believe that? She was putting so much traction on my arm she almost pulled me off the plinth!” If it wasn’t so sad the whole silly affair might have been even more humorous than it was. I had a little fun, but I couldn’t help but feel disheartened at the epidemic of gullibility in the room. If contemporary PT practice embraces the MFR theory and techniques I experienced I can’t help but think we are in deep trouble as a profession.

There’s an old fable that goes something like this…” One year in a certain kingdom the harvest came in poisoned with mold and all who ate it lost their minds. Because there was nothing else to eat, the king said, ‘We have to eat this grain or we’ll all die but let there be a few among us who at least remember that we are crazy.” I for one, think we must be nuts if this kind of nonsense can pass itself off as a legitimate part of the physical therapy profession. Is it just me or are we all quacking up?

Informed Consent ..... Chiro Style

Informed Consent ..... Chiro StyleSatire, by the Sitemaster

Now Mrs Jones, I need to get your written consent before I use the following technique on you.

This is a very controversial technique, about which there is a great deal of disagreement between chiropractors, on the one hand, and everyone else in the medical and scientific world, on the other hand. Medical doctors and Physical Therapists have ceased to use this technique, but we chiropractors refuse to do so.

First I'm going to provide you with the standard chiropractic explanation as to why I feel it is necessary to do it to you, and then I'll provide you with the scientific explanation provided by everyone else in the healthcare system. You can then make your decision based either upon a chiropractic explanation, or upon a scientific explanation.

I believe you need to have your upper cervical spine adjusted, because we chiropractors believe that this is the most important part of the spine to manipulate. Since all people have subluxations, I need to make sure that you don't have any uncorrected subluxations in that area. According to the great B.J. Palmer, the son of the founder of this great profession, adjusting the top vertebrae in the spine (he called it the HIO - Hole In One - technique) makes it unnecessary to adjust any of the other vertebrae.

Even though you are here because of a sprained ankle, and have no symptoms from your neck, I am only going to provide you with a chiropractic diagnosis and treatment. (Thus I can ignore the medical diagnosis of a sprained ankle.) By correcting your subluxations, your Innate Intelligence will be better enabled to heal your body, including your sprained ankle (which was no doubt caused by having subluxations in the first place!).

Now the scientific explanation sounds quite different, but the law obliges me to provide you with this information (which I consider to be complete nonsense).

I would like to manipulate your cervical spine for a totally unrelated condition, which can't even remotely be affected by this treatment. In other words this is a totally unnecessary treatment, which places you at a small risk of receiving a stroke. If that happens and you're lucky, you'll die, otherwise you might become a paraplegic. It is also a totally unnecessary risk, since your neck can be treated using other methods with less risk.

Now will you allow me to perform this totally unnecessary and risky technique on you? After all, I'm not called a "chiropractor" for nothing! It is my duty to perform this procedure, otherwise you won't feel you have received chiropractic treatment, and I won't feel like I'm performing up to par.

What's your answer? Will you sign on the line?

Mrs. Jones, why are you so pale? Why are you getting up and walking away? Now, NOW, there is NO need to RUN out the door!

MRS. JONES! PLEASE COME BACK! YOU HAVE UNCORRECTED SUBLUXATIONS AND ARE AT RISK OF DYING A PREMATURE DEATH!

WITHOUT MY INTERVENTION, UNIVERSAL INTELLIGENCE CANNOT COMMUNICATE WITH YOUR INNATE INTELLIGENCE, AND SUCH A BREAKDOWN IN COMMUNICATION IS UNHEALTHY! SUBLUXATIONS ARE THE ORIGINAL SIN, AND THEY MUST CONTINUALLY BE REMOVED THROUGH PARTAKING IN THE SACRAMENT OF THE CHIROPRACTIC ADJUSTMENT.

DesignDecision tree-based analysis was conducted using population-based vaccination coverage, published vaccine efficacies, historical data on disease incidence before vaccination, and disease incidence reported for 1995-2001. Costs were estimated using the direct cost and societal (direct and indirect costs) perspectives. Program costs included vaccine, administration, vaccine-associated adverse events, and parent travel and time lost. All costs were inflated to 2001 US dollars, and all costs and benefits in the future were discounted at a 3% annual rate.

ParticipantsA hypothetical 2001 US birth cohort of 3 803 295 infants was followed up from birth through death.

ConclusionRegardless of the perspective, the current routine childhood immunization schedule results in substantial cost savings.

Author Affiliations:National Immunization Program, Centers for Disease Control and Prevention, Public Health Service, US Department of Health and Human Services, Atlanta, Ga. Dr Yusuf is now with UNICEF, New Delhi, India.

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In such a target-rich environment, it is hard to know where to start first. Let's start with her contention that the lack of evidence of harm comes from "the CDC's easily flawed and manipulated population studies."

To the contrary, numerous large epidemiologic studies from the United States, Britain and Denmark have failed to find a link between thimerosal exposure and autism, Asperger's syndrome or other autistic-spectrum disorders. In a presentation by Dr. Elizabeth Miller to the Institute of Medicine's Immunization Safety Review Committee last year, she reviewed an analysis of 103,043 children born in Great Britain between 1988 and 1997. The children received a cumulative mercury dose of 75 micrograms (mcg) in their diptheria, tetanus and pertussis (DTP) vaccine doses by 4 months of age and were followed for at least eight years.

Paradoxically, the DTP vaccine seemed to be protective against the development of autism.

In perhaps the largest cohort studied, Anders P. Hviid of the State Serum Institute in Copenhagen studied the cohort of all children born in Denmark between Jan. 1, 1990, and Dec. 31, 1996 (467,450 children), comparing children vaccinated with thimerosal-containing vaccines with children vaccinated with thimerosal-free versions of the same vaccines. After 1992, the government quit producing the thimerosal version. Results of the study published in JAMA Oct. 1, 2003, found "the risk of autism and other autistic-spectrum disorders did not differ significantly between children vaccinated with thimerosal-containing vaccine and children vaccinated with thimerosal-free vaccine." Moreover, no dose-response association was noted. Interestingly, Hviid noted no decrease in the rate of autism in Denmark after thimerosal was removed from the DTP vaccine.

The cause of autistic-spectrum disorders remains unknown, but the increase has been documented in foreign countries that either discontinued use of thimerosal in vaccines or never used it in the first place. It is at least as likely that the increase is due to changes in diagnostic criteria or increased awareness of the disorders by parents and physicians as childhood vaccines.These disorders are usually diagnosed in the first two years of life when multiple vaccines are given, suggesting the logical fallacy post hoc ergo propter hoc (after this, therefore because of this). More simply, association (an action followed by a result) does not equal causation (an action causing a result).

While the subject of preservatives in vaccines may seem arcane, the sort of misinformation and junk science presented in Ms. Dachel's letter is all too common on the Internet (and the advertisements of personal injury attorneys), needlessly frightening parents and leading them to trade the small risk of vaccine injury for the all too real risk of the actual disease. For those wishing to know the actual risks involved without the hysteria of some of the anti-vaccination Web sites, I recommend checking out http://www.quackwatch.org for a more reasoned discussion of the issues involved.

David E. Hanson, M.D.

Savanna

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....and just when you think you've seen it all in the chiropractic zoo, this one comes along. Why am I not surprised?..... :

Chiropractic Footbath cures everything

HOUSTON -- Patients are pouring into a north Houston doctor's office for help with everything from cancer to constipation. The treatment involves a footbath, but does it really provide a cure? The KPRC Local 2 Troubleshooters went undercover to find the answer.

A hidden camera caught every crack and adjustment during a recent visit to Cypress Chiropractic, located at 9950 Cypresswood Drive. The appointment seemed routine until Dr. Brooke Fowler had the undercover patient, a KPRC producer, put her feet into what looked like a regular footbath.

After soaking for several minutes, Fowler said the machine pulled out metal from the pores of the producer's feet.

"See the black chunks? Those are mostly metals and you can pick up metals from tap water, smoking, tobacco or even second-hand smoke," Fowler said.

They are toxins that Fowler and her husband, Dr. Mark Hopkins, who also works at the clinic, said might add to the producer's PMS problem.

But the KPRC Troubleshooters found patients soaking for all sorts of medical conditions.

"I brought my husband because he had a cyst on his head," a patient said.

Another woman did not want to be identified, but she does want to know what's in the water.

"He will treat (you), no matter what you have. You can go in there and he'll say, 'Sure, stick your feet in here. I'll fix you up,'" the woman said.

Several members of her family are coming to Cypress Chiropractic for everything from depression to skin problems.

Cypress Chiropractic's office pamphlets said the footbaths help with arthritis, migraines, and even cancer.

The doctors told patients that the colored specs in the tub were toxins pulled from their bodies and each poison is a different color.

"He'll keep you going back week after week after week," the woman said.

Each week, patients are charged hundreds in supplements, office visits and footbaths, the station reported.

So, the Troubleshooters went to Rice chemistry professor Andrew Barron to find out what the patients are actually getting for their money.

"Absolutely nothing is really the straight answer," Barron said.

He tested the water from the KPRC producer's footbath.

"We've got calcium and sodium, which we would expect," Barron said.

He found metals, but no toxins that could physically come through the pores of someone's feet.

"To be pulling out chunks of magnesium or copper, if that's the claim, seems difficult," Barron said.

Dr. Charles Layne, with the University of Houston's Department of Health and Human Performance, read the research on the footbath, but still has questions, specifically about the metals that are supposedly toxic.

"Even if these could be drawn out or are being drawn out by this process, I don't understand why these are toxic," Layne said.

The manufacturer of the footbath claims a battery creates a negative charge in the water that helps to grab onto the toxins in a patient's body and suck them out.

Barron said the problem is not with the studies, but with the science.

"There is no evidence that it would have any effect whatsoever, other than having a pleasant feeling," he said.

"We see patients every day come in and they get better. And like I said, we've got testimonials to prove it, tons of them," Hopkins said.

As a chiropractor, Hopkins said he makes it clear he does not treat conditions. He treats patients who suffer from conditions. And as long as they're happy, he said he would continue letting them soak.